RN Case Manager (40hr)

Beth Israel Lahey Health•Needham, MA

19d•Onsite

About The Position

The RN Case Manager (CM) facilitates the coordination of care for patients admitted to medical, surgical services, ICU, and as needed for outpatient areas including but not limited to the Emergency Department, PACU and Preadmission testing. The case manager consults and collaborates in activities related to the establishment of appropriate levels of care. He/She reviews patient's medical records and participates in direct and indirect communication with care givers to ensure continued appropriate level of care, including the level of care of elective surgical cases. The case manager provides ongoing education to the physicians and nurses about levels of care. The RN Case Manager performs, consults, and collaborates in activities related to the development of safe, effective, and efficient discharge or disposition of patients for an assigned patient caseload. This role is patient-focused, outcome-oriented and based on professional nursing practice guidelines and the Standards of Practice for Case Management. It functions within a multidisciplinary practice model.

Requirements

Associate's degree in Nursing required.
License Registered Nurse required.
3-5 years related work experience required in Acute care or managed care setting with two years prior experience in case management.
Knowledge of discharge planning practices, understanding of utilization review practices including third party payer and insurance plans and acute hospital Interqual criteria, current knowledge of federal, state, and regulatory requirements guiding case management practice.
Experience with computer systems required, including web based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint or Access.
Ability to make decisions that are guided by general instructions and practices requiring some interpretation.
Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.
Ability to set goals and determines how to accomplish defined results with some guidelines.
Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.
Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.
Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.
Ability to lead collaborative teams for larger projects or groups both internal and external to the Medical Center and across functional areas.
Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s).
Resolves service issues in the assigned unit(s) in a timely and respectful manner.
Employees in this job must be competent to provide patient care to the following age groups: Neonatal: Birth to 6 months, Youth: 6 months to 16 years, Young adult: 16-30 years, Middle Age: 30 - 60 years, Elderly: 60 -.
Light work: Exerting up to 20 pounds of force frequently to move objects. Some elements of the job are sedentary, but the employee will be required to stand for periods of time or move through out the hospital campus.

Nice To Haves

Bachelor's degree in Nursing preferred.

Responsibilities

Performs utilization management, care coordination, and discharge planning for assigned patient caseload.
Coordinates and organizes a timely and accurate review of each medical record for severity of illness and intensity of service, utilizing Interqual criteria, to satisfy state and federal regulations by reviewing and investigating patient history, presenting symptoms, clinical status and treatment.
Utilizes the case management process of assessment, planning, implementation and evaluation to create case management care plans for assigned patients.
Facilitates multidisciplinary collaboration on a daily basis.